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Clinical Trial
. 2014 Jun;36(6):848-52.
doi: 10.1002/hed.23385. Epub 2013 Sep 2.

Transoral robotic approach to carcinoma of unknown primary

Kasim Durmus  1 , Sanjeet V Rangarajan, Matthew O Old, Amit Agrawal, Theodoros N Teknos, Enver Ozer
Affiliations
Clinical Trial

Transoral robotic approach to carcinoma of unknown primary

Kasim Durmus et al. Head Neck. 2014 Jun.

Abstract

Background: The management of carcinoma of unknown primary (CUP) is one of the challenging conditions in head and neck oncologic surgery. Despite various diagnostic tools, the primary tumor site in more than half of cases remains unidentified. The purpose of this study was to assess the feasibility and efficiency of utilizing transoral robotic surgery (TORS) for the diagnosis and treatment of CUP in the head and neck.

Methods: In this prospective, single-institutional, clinical TORS trial, 22 of 181 patients were treated for CUP between 2008 and 2012.

Results: Among all those 22 patients, primary tumor site identification and complete tumor removal was achieved in 17 patients (77.3%) with TORS. Tonsil (59.1%) and base of tongue (18.1%) were identified as the most common tumor locations.

Conclusion: Together with panendoscopy, directed biopsies, and positron emission tomography (PET)/CT, TORS is a valuable option in the identification and treatment of primary tumor sites.

Keywords: carcinoma of unknown primary; daVinci; transoral robotic surgery.

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Conflict of interest statement

The other authors disclosed no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Intraoperative decision-making algorithm for cancer of unknown primary (CUP) treated with transoral robotic surgery (TORS).
FIGURE 2
FIGURE 2
Transoral robotic radical tonsillectomy and ipsilateral lingual tonsillectomy. (A) Surgery started as routine transoral radical tonsillectomy. (B) Resection is extended to include the ipsilateral lingual tonsil. (C) Excision is completed. [Color figure can be viewed in the online issue, which is available at wileyonlinelibrary.com.]
See this image and copyright information in PMC

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